<html>
<body>
<center>
<form>
<fieldset>
<h1>User Information</h1>
<table width="100%" border="1">
  <col align="right" />
  <col align="right" />
  <tr>
    <th>Name: <input type="text" size="48%" /></th>
    <th>Email: <input type="text"  size="48%" /></th>
  </tr>
  <tr>
    <td>Password: <input type="text" size="48%" /></td>
    <td>Phone: <input type="text" size="48%" /></td>
  </tr>
  <tr>
    <td>Confirm: <input type="text" size="48%" /></td>
    <td>Title: <input type="text" size="48%" /></td>
  </tr>
   <tr>
    <td align="left">Birthday:Month <select>  
	<option>01</option>
    <option>02</option>
    <option>03</option>
    <option>04</option>
	<option>05</option>
    <option>06</option>
    <option>07</option>
    <option>08</option>
	<option>09</option>
    <option>10</option>
    <option>11</option>
    <option>12</option>
	</select>
	Day <select>
	<option>01</option>
    <option>02</option>
    <option>03</option>
    <option>04</option>
	<option>05</option>
    <option>06</option>
    <option>07</option>
    <option>08</option>
	<option>09</option>
    <option>10</option>
    <option>11</option>
    <option>12</option>
	<option>13</option>
    <option>14</option>
    <option>15</option>
    <option>16</option>
	<option>17</option>
    <option>18</option>
    <option>19</option>
    <option>20</option>
	<option>21</option>
    <option>22</option>
    <option>23</option>
    <option>24</option>
	<option>25</option>
    <option>26</option>
    <option>27</option>
    <option>28</option>
	<option>29</option>
    <option>30</option>
    <option>31</option>
	</select></td>
    <td>Address: <input type="text" size="48%" /></td>
  </tr>
   <tr>
    <td align="left">Gender: <select>
	<option>Male</option>
    <option>Female</option>
	</select></td>
  </tr>
</table>

<p align="middle"> <input type="submit" value="Submit" /></p>


</fieldset>
</form>
</center>

</body>
</html>